The People's Perspective on Medicine

Can Antibiotic Help Post-Colonoscopy Problems?

One reader had persistent digestive distress following a colonoscopy. An antibiotic prescribed for something else solved the post-colonoscopy problems.

Colonoscopies save lives. The procedure in which a gastroenterologist examines the lining of the colon for pre-cancerous growths called polyps allows for early detection of colon cancer. In addition, the polyps can generally be removed in the course of the procedure so that they can’t cause any further trouble. Some people postpone a colonoscopy because they worry about the preparation required. During this process, the colon is flushed out to cleanse it so that any growths won’t escape detection. But once you wash all the bacteria out of the bowel, how do they re-establish themselves? A healthy digestive tract has a flourishing ecological system of microbes. Perhaps removing bacteria and reducing diversity could help explain why some patients have reported post-colonoscopy problems.

Coping with Post-Colonoscopy Problems:

Q. I recently read about a 60-year-old man having problems after a colonoscopy. I had similar trouble after the procedure with alternating diarrhea and constipation, as well as a lot of pain that the doctor called Irritable Bowel Syndrome. He suggested narcotics, in which I had no interest.

I put up with the pain and mess for about five years. Then I got a cut on my arm while I was working on a construction site. It became infected, and the doctor gave me a broad-spectrum antibiotic. The day I took the last dose of the antibiotic, my bowel problems cleared up and did not return. Apparently, I had picked up a stubborn infection from the colonoscope.

Infection from the Colonoscope?

A. Your story is fascinating. Colonoscopes can sometimes be contaminated (American Journal of Infection Control, Aug. 2015). Of course, there is no way to tell if that is the source of your post-colonoscopy problems.

Reduced Bacterial Diversity:

Another possibility is that the “cleansing” of the digestive tract in preparation for the colonoscopy disrupted the balance of microbes in your digestive tract (European Journal of Gastroenterology & Hepatology, May 2016).

The impact of antibiotics on the microbes living in the digestive tract is not yet well understood (Cell, Sep. 6, 2018).  Often, antibiotics kill gut microbes indiscriminately. Consequently, people may sometimes have trouble re-establishing their original ecological balance. However, it sounds as though your antibiotic experience was far more positive since it solved your post-colonoscopy problems.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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  • Ofstead CF et al, "Persistent contamination on colonoscopes and gastroscopes detected by biologic cultures and rapid indicators despite reprocessing performed in accordance with guidelines." American Journal of Infection Control, Aug. 2015. DOI: 10.1016/j.ajic.2015.03.003
  • Drago L et al, "Persisting changes of intestinal microbiota after bowel lavage and colonoscopy." European Journal of Gastroenterology & Hepatology, May 2016. DOI: 10.1097/MEG.0000000000000581
  • Suez J et al. "Post-antibiotic gut mucosal microbiome reconstitution is impaired by probiotics and improved by autologous FMT." Cell, Sep. 6, 2018. DOI: 10.1016/j.cell.2018.08.047
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I too acquired an Hep A infection from a colonoscopy done at our local hospital, but could never prove it because of the longer incubation period of Hep A. Since t procedure is ‘mandatory’ for good health’, I am not sure there is an acceptable alternative for the patients.

After five years of struggling with dreadful bouts of diarrhea and nausea/vomiting after having my gall bladder removed, I was given Clindamycin for a gum infection. Have not had a digestive problem since. A friend had suggested ox bile, but the side effects worried me.
The occasional bout of intestinal upset now is controlled with macaroons and a c up of ginger tea. I also take a probiotic. Because I also have Celiac ( diagnosed from genetic testing and symptoms), I have to watch my diet carefully.

This is interesting. I had a similar situation after colon surgery to remove a stage 1 cancer in 2011. Nothing helped until I was prescribed the antibiotic Levaquin for a sinus infection years later. I noticed a significant improvement after six or seven years of misery. However, I did regress. I asked for Levaquin when I needed another round of antibiotics with the same positive results. My GI doctor started me on this once a week which also worked until I developed tendon problems. I asked him what kind of bacteria was the Levaquin targeting but he did not know.

Need to gain weight following a Sigmoid Resection & a Right Hemi-colectomy & removal of 61 Lymph Glands.

I was infected during a colonoscopy by a bacteria that I understand is rare in the US, hafnia alvei. I required hospitalization for 3 days, and continued to be very ill for many months after the infection, and eventually was diagnosed as having developed reactive arthritis (Reiter’s Disease) as a result of the colon infection. The reactive arthritis further developed to spondylitis, that I will deal with for the rest of my life.

I have had IBS for years, way before I got my first colonoscopy. Since polyps were found, I have a colonoscopy every 5 years. After last year’s procedure, my IBS really flared up. It had been quiet for several years ans I was feeling good. It has taken 8 months to get back to where it was. I take pre- and pro-biotics and eat healthy fiber. I don’t think I have an infection but will review this at my upcoming doctor’s appointment. Thank you for the information.

I think that they have still not solved the problem of properly cleaning methods for the equipment used in colonoscopies.

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